I would like to expand on my position on the upcoming changes to MediShield Life that was presented to Straits Times political correspondent Linette Lai for her article, "For all, for life? MediShield Life changes for cancer treatments explained" (Aug 28).

The article carried my quotes on the increase in Integrated Shield Plan (IP) premiums and how it would affect other healthcare coverage.

I also made the argument that any premium increase for those with IPs, or increased out-of-pocket costs for those without IPs, would be a direct consequence of reduced funding for some cancer treatment.

While the upcoming changes will lower the cost of some cancer treatments, others will become more expensive for patients.

Specifically, there are 94 (or one-third) out of the 274 treatments in the newly created Outpatient Cancer Drug List that will have no subsidies and have MediShield Life monthly claim limits reduced to below the existing $3,000 ceiling. Of the one-third of treatments, many are considered the standard-of-care for treating specific cancers and they may become more costly after the changes kick in.

Cancer is a heterogeneous disease where the type of tumour, condition of the patient, presence of other health conditions, and even the composition of the germs in our gut, can result in different responses to a particular treatment.

For patients not covered by IPs, a simple and speedy appeal process for special circumstances, as suggested by other commentators in the same article, would be crucial to ensure that every patient gets a fair fight against cancer.

How Ti Hwei

Vice-President, International Oncology and Market Access,

AstraZeneca